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In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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Drug delivery methods like oral inhalation, nasal sprays, transdermal patches, eye drops, intravitreal injection,  and rectal administration provide localized effects with reduced toxicity.
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Related Experiment Video

Updated: Jul 18, 2025

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Pharmaceutical Approaches to Normal Tension Glaucoma.

Maria Letizia Salvetat1, Francesco Pellegrini1, Leopoldo Spadea2

  • 1Department of Ophthalmology, Azienda Sanitaria Friuli Occidentale, 33170 Pordenone, Italy.

Pharmaceuticals (Basel, Switzerland)
|August 26, 2023
PubMed
Summary

Normal tension glaucoma (NTG) treatment often lowers intraocular pressure (IOP), but IOP-independent factors also drive progression. New therapies are needed for this vision-threatening condition.

Keywords:
glaucomatous optic neuropathyintraocular pressuremedical therapyneuroprotectionnormal tension glaucomatarget IOPvisual field defects

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Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Neuroscience

Background:

  • Normal tension glaucoma (NTG) is a subtype of primary open-angle glaucoma (POAG).
  • NTG accounts for 30-40% of glaucoma cases, characterized by normal intraocular pressure (IOP).
  • Its multifactorial pathophysiology involves both IOP-dependent and independent factors, not fully understood.

Purpose of the Study:

  • To review current literature on treatment strategies for Normal Tension Glaucoma (NTG).
  • To highlight challenges in developing effective NTG treatments.
  • To explore the role of IOP-independent factors in NTG pathogenesis and treatment.

Main Methods:

  • Literature review of studies on NTG pathophysiology and treatment.
  • Analysis of existing therapeutic approaches, including IOP-lowering and other strategies.
  • Discussion of current research on vaso-active, antioxidant, anti-inflammatory, and neuroprotective agents.

Main Results:

  • Intraocular pressure (IOP) reduction is the standard treatment, even within normal ranges.
  • IOP-lowering alone is insufficient for all NTG cases, indicating the importance of other factors.
  • Evidence for standardized, proven alternative treatments beyond IOP reduction remains inconclusive.

Conclusions:

  • NTG requires a deeper understanding of its complex pathophysiology.
  • Individualized treatment approaches considering both IOP and independent risk factors are crucial.
  • Further research is needed to develop effective, standardized therapies for NTG.